role of alcohol in breast cancer development and recurrence

paige-allyson

role of alcohol in breast cancer development and recurrence

paige-allyson

Alcohol has been pretty clearly implicated in the development of breast cancer and in risk of recurrence, particularly in ER+ breast cancers. I was a regular drinker for years prior to my diagnosis and am sure that this played a role, along with other factors, in the development of my cancer. I stopped drinking the day I received my full pathology report, because by that time I had studied up enough to be clear about the role of alcohol in raising estrogen levels, especially in post-menopausal women, and its role in helping tumors form new blood vessels, creating the blood supply they need to become established and progress.

It seems like among all the things I hear women talking about as ways to help themselves/prevent recurrence here at bc.org, there is little to no talk about the topic of alcohol. In view of the data this is pretty surprising to me.

So... are there others of you out there who are aware of this? Have your doctors ever asked about alcohol? (Mine didn't/don't- in fact my former PCP said that heavy regular drinking was "typical" among health care providers!). Have you changed (or considered changing) your alcohol consumption? This is not about blaming myself or anyone else for getting breast cancer in the first place- we know it has many causes and that there are plenty of women out there who drink or drink heavily and are fine (just like there are 2 pack a day smokers who live to be in their 80s and 90s ). I just want to do all I can to help myself survive now that I am more educated and am wondering if I am the only one who's made this change.

I've included a few links below for those who are interested, but there is tons more out there.

http://www.sciencedaily.com/releases/2004/12/041220023731.htm

http://www.breastcancer.org/tips/nutrition/new_research/20070230.jsp

http://www.hopkinsbreastcenter.org/artemis/200711/1.html

louishenry

But I love my wine!!!! Great post. I used to drink one glass of wine a day for many years with my meal and then maybe an extra one on the weekends. I asked the onc about it and he said "everything in moderation." Whatever that means. Now, I am slightly changed my habits. I stay away from it during the week and have a couple each night on the weekend. From what I've read, under 5 glasses a week is probably ok. I also take extra folate. I am highly er/pr, so lowering my circulating estrogens is important. Nada. 

Rosemary44

I'm still searching for that great red wine under $25 a bottle which means tasting.  I found one at $50 a bottle.. Pine Ridge cab.   No, I would not consider giving up alcohol.  I don't drink it often, but when I do enjoy a taste, I don't even think about anything other then asking myself, will I have to throw this bottle out too or just use it for cooking?

sandilee

allyson- I'm with you on this one. I'll miss it, though.

Most of my adult life, before my kids and while they were living with us, my husband and I drank very little. Maybe once a month we'd have wine with dinner out with friends.  These last couple of years, as empty-nesters, we've been out with friends a lot, and drinking a lot more. One of our favorite Friday night outings has been going to a local place that has wine tastings and then going to dinner, sometimes with more wine.  In October, we toured Tuscany, enjoying Italian wines along with the scenery and culture. Adult pleasures- but not for me, anymore., sorry to say.

      

  Maybe because my scar is still tender that I have this resolve, but I

believe that alcohol is harmful to my health, and I'm determined to do whatever it takes to stay healthy. I'm surprised that this is my most difficult give-up.  I thought it would be sugar, but I find by not eating sugar, I no longer want it. Drinking for me is a social thing- more about lifestyle and enjoying life and it's pleasures, so I guess it shouldn't surprise me that it's tough to give up.    

lisametoo

Dear Allyson,

Those are great articles.  My mom was a WINO.  She still hasn't given it up, now only drinks organic red on occaision.  I have to watch it myself.  Nothing better than dove chocolate and merlot.

Anonymous

Allyson....Thank you for having had the courage to identify what you believe might have been a relationship between your alcohol consumption patterns and the development of your breast cancer. I'm with you all the way on this and think that this is an appropriate venue for me to identify myself as a recovering alcoholic. I will go even further and add that many of you "normies" (as we, in AA, often call non-alcoholics) might be somewhat surprised to know what a huge number of female alcoholics, at least those I meet in the rooms of Alcoholics Anonymous, have had, or have BC. The numbers are probably staggering! For this reason, I'd say it is wise for women who think that they drink excessively to cut back or quit. As for the normal drinkers, I'll say what I usually do when we try to decide what "caused" our cancer....and that's that it is most likely just a huge crap shoot or at least a combination of lots of smallish factors that one can't possibly worry about!

Thanks again, Allyson, for providing me with the opportunity to share this and, in doing so, possibly help other women who worry about drinking alcoholically and getting BC. If you do and want to share about it privately, please feel free to PM me at any time.

~Marin

paige-allyson

I am SO glad I posted on this topic! Thank you all for your responses. It seemed so odd to me that I had not seen anything regarding alcohol come up here at bc.org when the research literature more and more seems to be showing a link between alcohol consumption and breast cancer (and other cancers)  that may not be so different than the relationship between tobacco use and lung cancer (and other cancers). I am astonished and disappointed that medical providers, as far as I can tell, rarely raise the topic of alcohol use. Not one of my doctors ever asked me about my drinking habits or recommended avoiding alcohol as an important factor in surviving post-dx.

I raised the topic in part because it is so important to breast cancer prevention and survival and yet so conspicuously absent from our discussion boards. Although I don't have a particular identity as an alcoholic I absolutely acknowledge that for me, and I know for many other women, that drinking any alcohol at all can lead down that slippery slope to a level of drinking that is not healthy and sets in motion a variety of biological processes known to promote tumor development.

Although I was always very health conscious in other ways I tended to minimize how bad the regular drinking was for me even though on some level I knew I was really pushing it. I tried to cut down at various times but never really made that commitment. I know that a huge part of this was that I had a deeply rooted and as it turns out totally irrational belief that I could not have an enjoyable life without alcohol being a part of it. I can honestly say that one of the biggest "gifts" that came with my breast cancer diagnosis was an absolute willingness to walk away from alcohol and never look back. It is absolutely the best thing I have ever done for myself- wish I did it years ago but I am not going to brood on this point.

Like Marin I am happy to talk with any one out there who is concerned about her alcohol use- either here on the thread or by PM.

Marin- thank you for stepping up with me and sharing your experience, it really made my day.

Allyson

Anonymous

Allyson...I think we make a good team, don't you? I'd like to offer some possible reasons as to why we don't hear much stress put on the relationship between alcohol and bc. One reason may be the reluctance of health care providers to give too much credence to the relationship because they, too, drink more than moderately. There is still such a severe stigma around alcoholism, one that many choose to ignore, but which they still ascribe to, whether consciously or unconsciously. So, in giving alcohol weight as a factor that contributes to BC, many would feel the need to quit or cut back themselves or advise their patients to do so. Who wants to be that guy, the stone-crasher? Instead, they defend vociferously their right to "fully enjoy life" by drinking alcohol. Whatever. Related to this is what I can only call embarassment or discomfort on the parts of many to even discuss alcoholism. I can't tell you how many times I've told a new doctor or NP that I'm an alcoholic, only to have them offer excuses for me and brush it aside, then quickly drop the subject. They'll say things like "Oh, but you probably weren't a real alcoholic or a bad alcoholic?" Huh? I usually tell them that it is a part of my medical history that they need to know and not information that I'm asking for their judgment or blessings on. Then there's also the financial aspect, both from the clinician's POV, with patients getting ticked off and changing docs, to the larger fact that there's money in alcohol and the industry may take issue with the publicizing of a connection.

Finally, I'll say that I, like you (but probably to a much greater extent) was never happier than i am today, having left alcohol behind in favor of full consciousness and a much livlier and more colorful view of the world! I attribute this not only to just not drinking but to my having learned how to live more compassionately and joyously, as a result of my BC experience as well as my experience in 12-step living. I wouldn't change any of it for the world!

~Marin

Little-G

I wrote back on another thread that you had posed this question on, but I'll write on this one too.  I have always drank alcohol, pretty  much since I was 17.  Not excessively and not where its ever been a problem.  I drank all the way thru my radiation tx's.  I probably have about 4 glasses of wine a week on the average.  None over the last 4 weeks because I've had bronchitis and for some reason my sense of taste is gone.  I drink the red wine because I enjoy the flavor.  I did talk to my onc. about it when I was first dx.  I've had 2 oncs.  One told me to stop drinking, the other said it was fine.  So..go figure.  My naturopath said stop drinking.  But..I'm not going to do that.  If I stop it would simply be because I no longer enjoy the taste, not because of the fear of breast cancer.  I still use deodorant, and apparently that's been linked to it as well.  Also many of the preservatives in our food, and the crap that is in our air.  So..where does it start and stop?  I don't know.  I think its whatever each of us chooses to do for ourselves.  And what we believe will make the difference to ourselves.  There are so many "maybe's" and "what if's" in this.  So many.  I would guess this is why there isn't cure.  I could go on and on with the poisons we use every day, to clean, to cook, all of it.  So...my little glass of wine in the entire scope of this mess that's been made of the planet, just seems insignificant to me in my little place of the world.

g

suecco

Well you know what my onc told me to enjoy life to the full, a few wines wont make my cancer worse, if its gonna grow it'll grow no matter what I eat or drink,

cheers ladies!!

iodine

Hi little g, I agree with what you have said.  I've said many times before that untill they come up with a confirmed cause I'll be like Marin and determine that it's a crap shoot.

After the thing about french fries being a contributing factor, I refuse to listen to much "they" come up with.  I've met too many here who lived the life style recommended for long and healthy life , only to be diagnosed. 

As far as stopping alcohol, I would never argue with someone who feels that abstinence is making their lives better!  Both my parents were drunks (not alcoholics) and I respect anyone who can identify something to make their lives better and also for those around them.

paige-allyson

Not to worry- no one here (i.e. me) is interested in leaping through the computer screen and yanking anyone's wine bottle or similar from their hands LOL . The point I am bringing up is that alcohol has a known relationship to the development and progression of breast cancer- particularly ER+ after menopause (my situation).

I believe firmly in a woman's right to choose...in this case to drink or not...but I think it only fair that this be an informed choice, which for many I think it is not because the matter is not discussed.

Cheers with my cup of green tea . Allyson

iodine

oh, and your doc's remarks about heavy drinking being a regular thing among health care providers is, well, bs. 

koshka1

Hello,,,

Me2!! I am sooo glad that someone started this thread.

I too am a wine drinker... have always had a glass of wine in the evenings...for me it has been like that cup of coffee in the morning.

I now am sticking w/ the organic wines as much as I can, and am limiting my glass of evening wine to the weekends.

I am not going to stop my life and what I enjoy because of this stupid cancer, but I guess I cannot "knowingly" continue my old ways and sleep at night.

Hugs kosh.....

PS....trying to cut down on the coffee consumption too...lol.

Lolita

Sometimes I go crazy thinking about the percentage of risk reduction or risk increase.  I drink green tea, too.  Some studies say thats a 30 percent reduction in risk.  Moderate to heavy alcohol use is a 10-30 percent increase although there are some red wine theorists who claim its an anti-oxident.    I exercise, some say that's another 40 percent reduction.  They really don't know.

I personally am less concerned about the occasional glass of wine than the fact that I live in a toxic corridor:

http://www.usnews.com/blogs/thinking-harder/2008/2/7/bootlegged-federal-report-spells-trouble-for-8-states.html

 I also think that chemical and manufacturing interests want to keep us as far away as possible from the cause of many of our cancers so that we can worry about wine and green tea and when we had our babies and not pay attention to our risk that comes from breathing poisoned air, eating poisoned food, and drinking poisoned water. I am agreeing with Little G on this one.

Little-G

Allyson,

I don't think anyone is worried about that.  You wanted some opinions, so there they are.  I appreciate you wanting to share that knowledge and I'm sure there are woman who do not know about the studies.  My point is there are an overwhelming amount of unknowns out there to say where the cancer comes from.  I sometimes blame mine on stress.  But really, who knows.  My thoughts are if we picked everything apart as to what was "healthy", we would starve and thirst to death.  Our planet and resources are so messed up,there is no possible way for anything to be truly healthy anymore, if you follow it down to the end.  So, while someones cancer may stem from alcohol, I would guess there are many more that stem from something else.  It would be nice if all of the choices were informed choices, but sadly it dosn't always work that way.  But for myself, thank you for brining up this topic and hopefully it helps someone. 

g

Little-G

PS  I have to agree with Dottie on the physician thing.  I think they are humans just like us.  Not all of us drink and those of us that do, not all of us are heavy drinkers.  Again...just my thoughts. 

g

Cynthia1962

I've seen the issue of breast cancer and alcohol brought up on this board more than a few times since I joined.  I thought it was just a given that most of us know there's an association.  I thought, though, that the association is with drinking an average of 3 or more servings of alcohol daily.  I'll have to look that up.

When I was dx'd, I quit drinking what little alcohol I drank and didn't have alcohol again until last month.  I now drink maybe one drink a week or less and I don't feel it increases my risk of a recurrence.  

My onc has asked me a couple of times, at least, if I drink.  I said no, because I wasn't then, so I have no idea why he was asking or what he would have said if I'd have had a different answer.  I'm pretty sure my gp asked me, too.   

Maybe, I'm just being stubborn, but I'm leaning toward the thinking that we really have very little idea of what increases or decreases risk of breast cancer.   I personally know two women who lost their mom to breast cancer when she was in her 40's.  They both drink, one moderately to heavy, and the other is an alcoholic.  They both smoke, and the moderate drinker hasn't met a vegetable she likes.  Do they have breast cancer?  Hell, no!!!  And, here I am...the skinny, breastfeeding, vegetarian, who avoided everything in excess, as well as known carcinogens.  Boy, do I feel like a fool.  

Cynthia 

Little-G

Hi Cynthia,

Don't feel like a fool!!  You do what you do for the reasons you believe, and that is good enough!  I bet we all have at least one thing we don't do because we think it will up our risk.  And I bet there are as many different things as there are of us.  None of us is wrong or right.  If they had the cure, we might not be chatting right now.  My thoughts are to do what makes you feel good about yourself.  Be a good human.  Until they can pin point what gave us the cancer, its all we can do.  Enjoy that glass of alcohol and that salad!  :-)

g

LUVmy2girlZ

Cyn ~

I was just going to post something similar....I only drink socially which is not enough for me as far as THAT goes,( however, when I did...it was no wine it was a martini or Margarita....making up for all the times I didn't I guess...but 2 was usually my "limit".... no history of BC in family.  Non-smoker, eat healthy ...my "faults" is chocolate!!  Call me a rebel ! LOL

I don't live in the "toxic corridor"...although I plan on e-mail relatives that are.  Not even "stressed" person....

I have DCIS...yes, but I HAD to have a mastectomy followed by 36 rounds of rads ( due to a positive margin )

I think no one knows really how cancer begins...lets just pray it ends!

koshka1

Hello,,me again.

Ya know...Cynthia has a good point.

Although I had my glass of wine each evening... I did eat organic food for many years, lots of veggies, all natural cleaners, cleansers, hair products,,,you name it.  I have taught aerobics and yoga for over 15 years, and have no family history of any cancer.  I am quoted to be the most healthiest out of all my friends.

And I still got breast cancer.

I think, if they knew what caused it, triggered it, made it grow, we would all know about it by now.

I have made a personal choice to reduce my alchohol basically because it allows me "to control" some of this,,,, i know it sounds crazy.

I think everything in moderation is the best.

And remember to LIVE!!!

Kosh.......

paige-allyson

Wow! Things have been busy here while I was at work! I had no idea that my post would generate so much energy! I am really interested in what everyone has to say and will keep up as energy and time allow. As the "coffee lady" used to say on the old SNL sketch, "tawk amongst yaw-selves."

Cynthia- My impression that a couple of glasses a week is not seen as a big issue for most women. Very interesting that your doctors did ask about alcohol. Lolita- your point is well taken on the chemical and manufacturing interests.

In general- the point I brought up is not about alcohol as a single causal factor of breast cancer, we all know that bc, like most cancers, is a multifactorial disease process that takes place over many years often before it is even detectable. Nevertheless, there is a correlation between alcohol consumption and breast cancer with risk increasing as alcohol consuption increases. Some of the processes by which alcohol promotes tumor growth (angiogenesis for example). We don't have to like it and it doesn't mean that every woman who drinks or drinks heavily will have breast cancer, but it is what it is. Perhaps I should have titled this thread "An Inconvenient Truth." Oops, no...that title's already taken...LOL. I'm being a wise guy but really I am glad to have the discussion.

Bliz

I dont drink at all and still got it, so ???? 

I think the bottom line is "they dont know."  Sometimes I feel we are just flogging ourselves by looking for answers, when there may not be any.

Cynthia1962

Thanks, Ladies, for reminding me that the most important thing is to enjoy whatever it is we choose to do during the time we're alive. 

Kosh - yes, I agree that I think we sometimes choose a path based on how in control it makes us feel.  If I hadn't already done so many things right, I would be turning to those things now to help me feel more in control.  lol

Luvmy2girls - mastectomy and rads - that's awful.  I had 33 and felt that was quite enough.  You're right, we need an end to this disease and now!

g - you're right, of course, that all we can do is the best we can with the info we have now...which, unfortunately, isn't much.  

Cynthia 

mailman

Interesting comments and views regarding alcohol and whether or not to consume a glass of wine, a margarita,a beer, or whatever.  That said, I wonder if other countries where alcohol is not as readily available can shed some light on statistics and in particular the possible role it may play (if any) in bc.

Having some history in family counseling,  it should be noted that if a glass of wine a day prevents a pound of stress maybe it's a wash.  Stress is a much more destructive component to the body than a glass of red wine.  This is my opinion and I could be wrong.  I don't have any family members whom were dx with bc but I have a lot of family members, cousins, etc whom are very heavy drinkers. Have been for many many years and all of them are late forties early fifties at present.  Just a comment

paige-allyson

I think whether it's okay/not okay to have a glass now and then within the current recommendation of up to 6 drinks per week for women is up for debate. Heavier drinking has been clearly identified as a factor that increases risk. MarkAnthony you may well be correct that at the glass a day level the benefit could outweigh the risk, but this is unknown and really would be a great area for research. 

Tempting as it is and natural as it is to base our decisions regarding risk by looking right around us, this approach does not provide very accurate data on which to base our conclusions. That's why we have large research studies based on random samples, etc. Those of us who have been through breast cancer treatment know, for example, that our treatment recommendations are based on statistical predictions based on data obtained from thousands of women, versus being based on our oncologist's personal experiences with the patients he or she happened to see. The alcohol risk isssues work in a similar way.

The real concern again relates to regular, heavy drinking- particularly 3 or more drinks per day on a routine or daily basis, as this has clearly been identified as risky for bc and other cancers. Within the 6 drink a week guideline identified as safe for most women- we'll have to see.

As someone brought up- this issue of personal control plays a part in some womens' decisions. I have a strong need to control those factors that I can control in taking charge of my not recently so cooperative health. The things I can't control...they're on their own.  

Dx 5/18/2007, ILC, 3cm, Stage IIIa, Grade 2, 6/17 nodes, ER+/PR+, HER2-

paige-allyson

Here is an article that further addresses some of the issues we have been discussing:

http://www.ctv.ca/servlet/ArticleNews/story/CTVNews/20070927/alcohol_breast_cancer_070927/20070927?hub=Health

I am a bit overscheduled today but I will check in when I can.

LUVmy2girlZ

Ally ~

Interesting article...like you said, " Tawk amongst yaw-selves"LOL

I agree, everything in moderation that has been my motto !!! 

Fit Chick ~ a Life choice, amongst others, alcoholics "good/bad/indifferent or in the closet"....are dependent, it is a day to day choice and at times struggle...yet once you reach that point some don't miss it at all !  B/C or not...overall health with Liver, family/friends and a part of life for some is not fully lived.  Keep up the AA support !

berriesnblues

Allyson,

I'm glad you started this as it's been on my mind too! I have a few comments - one of the biggest studies on this topic, the Nurses Health Study, found that just 1/2 glass a day was associated with an increased risk. I think this is the least amount of any reported study so far. So nobody knows what a glass or two a week will do. But in that same study, women who also were taking folic acid, had no increased risk of BC. So I started taking my folic acid pill each day, along with everything else. Lo and Behold a report came out today linking folic acid supplementation with colon cancer!! Darn it. You really can drive yourself crazy with this stuff.



My other comment is I can't help wonder about my own situation over the last two years before diagnosis. I was never a big drinker or much of a beef eater but a year or two before diagnosis my husband and I got into the Sonoma Diet. It's a mediteranean way of eating with lots of grilling and a glass of wine with dinner each night. I ate more steak than I ever had before and got into the habit of wine most nights. I feel like writing the author, so much for that "healthy" diet. I don't think my cancer started because of this diet but I can't help but wonder if the red meat and wine certainly helped my cancer grow.



One last comment tho, like others have said you have to balance living life and enjoying what's important to you with living to prevent a recurrence. We can all make ourselves crazy trying to eat just the right stuff and avoid all possible risks. And we could still get a recurrence...It's a balance for each one of us to decide. Take care all - Laura

roseg

I've read articles that suggest that the differences in breast cancer between white women and oriental/asian women may be more related to the differences in their alcohol consumption than much else.

I think moderation is really the key, and if you can't be moderate then you're better off not drinking.  For me moderate is 1-2 drinks a week, which means  not every day. There are plenty of other ways to reduce stress.  

That said, there are so many things that seem to cause breast cancer. If you can drink moderately and aren't battling the scale then it doesn't seem like it hurts anything.